Purpose: This study was conducted to determine factors influencing changes in the self-esteem of multicultural adolescents over time. Methods: A longitudinal design was adopted to analyze secondary data. This study used the 2nd, 4th, and 6th year data of Multicultural Adolescents Panel Study (MAPS) collected by the Korea Youth Policy Institute. The linear mixed model was utilized to analyze self-esteem changes over time. Results: The factors of sex and age of the students, the mother’s Korean writing ability, and the Filipino or Japanese mothers had a significant effect on the self-esteem change of multi-cultural adolescents over time. Specifically, it was found that female students’ self-esteem was decreased by 0.04 (t=-2.39, p=.017) more than male students over time. As the subject’s age and mother’s Korean writing ability increased, self-esteem was decreased by 0.01 (t=-2.53, p=.011) and 0.03 (t=-2.52, p=.012) over time. In addition, compared to that of those who had mothers from Korea, self-esteem of those who had Filipino or Japanese mothers was decreased by 0.04 significantly. Conclusion Therefore, when developing a self-esteem promotion program, it is necessary to develop content by reflecting the characteristics of mothers as well as the gender and age of students. Furthermore, the significance of this study is in that it established a foundation for a positive self-identity of multicultural adolescents whose number is increasing recently by identifying factors affecting their self-esteem.

BACKGROUND: The typical Korean diet includes rice, which is usually served in a rice bowl. We investigated the effects of a meal plan using rice bowls of varying sizes on dietary energy intake (EI), body weight (BW), and blood glucose levels. METHODS: Forty-two obese women with type 2 diabetes mellitus were randomly assigned to use either a 200 mL small rice bowl (SB), a 380 mL regular rice bowl (RB), or to a control group (C). Both intervention groups were asked to reduce their EI by 500 kcal/day for 12 weeks and simple instructions for using the assigned bowl were provided. Dietary EI and proportion of macronutrients (PMN) were estimated from 3-day dietary records. RESULTS: Reduction of EI was more prominent in the SB group compared to the RB and C group, although EI decreased significantly from baseline in all groups. Carbohydrate and fat intakes of the SB group were decreased greater than those of the RB and C group. However, changes in PMN were not significant across the 3 groups. Reduction of BW and HbA1c levels in the SB group was more prominent compared to the C group. Although, BW and HbA1c were decreased significantly from baseline in both bowl groups. There was no statistical difference between the two groups. CONCLUSION: The small rice bowl-based meal plan was effective at reducing EI, BW, and blood glucose levels, and the observed reductions in EI, carbohydrate, and fat intake were greater than those of the regular rice bowl-based meal plan.
Blood Glucose ; Body Weight ; Diabetes Mellitus, Type 2 ; Diet, Diabetic ; Diet ; Energy Intake ; Female ; Humans ; Meals ; Obesity ; Weight Loss

BACKGROUND: Pain management in the terminal stage of advanced cancer is often complicated by opioid-related bowel syndrome and other problems. This study was conducted to investigate the safety and efficacy of ketorolac as an adjunctive analgesic in cancer pain management. METHODS: 10 acutely ill cancer patients suffering from pain, complications of advanced disease, and opioid side effects were included. Except one acute leukemia, all of the patients had metastatic solid tumors. Pain complaints consisted of visceral, somatic and opioid bowel syndrome. They were treated with intravenous morphine patient-controlled analgesia infused with a repeated ketorolac bolus dosing. Demographic data, cancer diagnosis, change of pre- and post-treatment morphine infusion rates, and days until pain control or relief of opioid bowel syndrome were evaluated. RESULTS: Excellent pain relief with improvement of opioid bowel syndrome was achieved in a majority of cases. Ketorolac showed good morphine sparing effects. None of the patients reported gastrointestinal side effects. CONCLUSION: Ketorolac appeared to be well-tolerated in the clinical dose range and for short-term use in acutely-ill terminal cancer pain patients. It also seems to be very effective in relieving opioid-related bowel syndromes.
Analgesia, Patient-Controlled ; Diagnosis ; Humans ; Ketorolac* ; Leukemia ; Morphine ; Pain Management*

BACKGROUND: This study was undertaken to investigate the analgesic efficacy and safety of gabapentin in central pain syndrome. METHODS: With a diagnosis of central pain syndrome, a total 24 patients were accumulated in the outpatient pain clinic. Patients had been stabilized in their analgesic regimen at least four weeks prior to the study. Anticonvulsants, if taken, were discontinued for two weeks for wash-out. Pretreatment baseline pain scores (visual analog scale and pain intensity score) were obtained. Oral administration of gabapentin 300 mg was started in all patients. Initial doses were given from 300 mg per day with gradual titration over two weeks until 1) the onset of analgesic effect, 2) the maximum of 2,400 mg per day, and 3) the onset of intolerable side effects. Dosage was adjusted weekly. At the four-week study end point, VAS, PIS, pain improvement scores judged by family members, drug efficacy, tolerability and overall evaluation were assessed. The incidence of side effects was also noted. RESULTS: Fifteen patients dropped out due to various reasons. Data was collected from 9 patients (male = 4, female = 5). Among these, 3 had strokes and 6 spinal cord lesions due to trauma, cancer metastasis or syringomyelia. The average disease duration was 4.2 years. Analgesic onset was within two weeks and the average dose taken was 477.7 mg. At the end of the study, the VAS score and PIS revealed significant pain relief. These results were objectively reflected in pain improvement scores observed by family members. The majority scored good or excellent in all scales of drug evaluation. Sedation was the most frequently reported side effect. Others included dry mouth, weakness, and diarrhea, which were spontaneously resolved with lower dose maintenance. CONCLUSIONS: Gabapentin showed analgesic effect for central pain syndrome at a lower dose range than any other neuropathic pain syndromes. It appears to have different analgesic dose requirements in this difficult pain syndrome.
Administration, Oral ; Anticonvulsants ; Diagnosis ; Diarrhea ; Drug Evaluation ; Female ; Humans ; Incidence ; Mouth ; Neoplasm Metastasis ; Neuralgia ; Outpatients ; Pain Clinics ; Spinal Cord ; Stroke ; Syringomyelia ; Weights and Measures

BACKGROUND: Hypertension and type 2 diabetes mellitus are major risk factors for cardiovascular disease. This study analyzed the changes in central aortic waveforms and pulse wave velocity as well as related parameters after treatment with valsartan, an angiotensin II type 1 receptor blocker, in patients with type 2 diabetes and hypertension. METHODS: We used pulse wave analysis to measure central aortic waveform in a total of 98 subjects. In 47 of these patients, pulse wave velocity measurements were obtained before and after 12 weeks of treatment with valsartan. RESULTS: In the central aortic waveform analysis, the aortic pulse pressure and augmentation index were significantly decreased after valsartan treatment, as was the aortic pulse wave velocity. Factors contributing to the improvement in pulse wave velocity were the fasting blood glucose and haemoglobin A1c levels. CONCLUSION: Short-term treatment with valsartan improves arterial stiffness in patients with type 2 diabetes and hypertension, and the glucose status at baseline was associated with this effect.
Angiotensins ; Arterial Pressure ; Blood Glucose ; Cardiovascular Diseases ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Fasting ; Glucose ; Humans ; Hypertension ; Pulse Wave Analysis ; Receptor, Angiotensin, Type 1 ; Risk Factors ; Tetrazoles ; Valine ; Vascular Stiffness ; Valsartan

No abstract available.
Angiotensins ; Diabetes Mellitus, Type 2 ; Humans ; Hypertension ; Vascular Stiffness

Selective termination can be used to preserve normal fetus from the other fetus with chromosomal, structural abnormality in multifetal pregnancy. This case is about twin pregnant patient who had undergone in vitro fertilization and embryo transfer. In 18 weeks of gestation, we found that one of the fetus had cranical encephalocele and was in concern for the termination by using ultrasound guided intrcardiac injection of 2.5 ml of potassium chloride solution. After performing this procedure the other healthy female newborn was naturally delivered at 38 weeks gestation with weight of 2.8 kg.
Embryo Transfer* ; Embryonic Structures* ; Encephalocele* ; Female ; Fertilization in Vitro* ; Fetus ; Humans ; Infant, Newborn ; Potassium Chloride ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnancy, Twin ; Twins, Dizygotic* ; Ultrasonography

OBJECTIVES: This study was conducted to examine the association of serum Vitamin D with insulin resistance and β-cell function in Korean health checkup examinees. METHODS: This study subjects were 374 healthy adults (199 males, 175 females) over the age of 20, who visited a general hospital medical center located in Haenam-gun, Jeollanam-do. To find the association of Vitamin D with HOMA-IR and HOMA-β, the used statistical analysis were ANOVA and ANCOVA. RESULTS: Of the study subjects, the level of serum Vitamin D defined by deficient group, insufficient group and sufficient group was 38.5%, 48.1% and 13.4%, respectively. According to the level of serum Vitamin D, the mean values of HOMA-IR were 1.92±1.08 in sufficient group, 1.99±1.04 in the insufficient group and 2.91±1.05 in deficient group and there were statistically significant different(p<0.001). The mean values of HOMA-β were 84.69±1.07 in sufficient group, 78.41±1.04 in the insufficient group and 80.48±1.04 in deficient group, and there were not significant. As a result of ANCOVA, adjusted mean of HOMA-IR were statistically significant different (p<0.001), but those of HOMA-β were not statistically significant according to the level of serum Vitamin D. CONCLUSIONS: The insufficient level of serum Vitamin D was relatively high in healthy adults who live in rural area, and it was found that HOMA-IR significantly increased when Vitamin D was deficient. To prevent insulin resistance or diabetes, it is necessary to provide sufficient information related to sufficient production of Vitamin D such as Vitamin D supplement, sun exposure, food intake and etc.
Adult ; Eating ; Hospitals, General ; Humans ; Insulin Resistance* ; Insulin* ; Jeollanam-do ; Male ; Solar System ; Vitamin D* ; Vitamins*

PURPOSE: Gastric variceal bleeding in cirrhotic patient is an emergent, life threatening disease of which the adequate treatment is still in dispute. The periesophagogastric devascularization (PD) would be the alternative operative procedure. The aim of this study is to evaluate the safety and long-term results of PD for the gastric fundal variceal bleeding. METHODS: A retrospective analysis was made of fifty-two patients with gastric variceal bleeding who underwent PD with or without fundectomy from August 1994 to March 2006. We evaluated the clinical characteristics, operative morbidity, mortality and long-term follow up results. RESULTS: The operative morbidity was 34.9% and overall mortality was 17.3%. The Child-Pugh classification at operation, the number of previous varix bleeding episode, the success of preoperative intervention, splenectomy, esophageal transection, and ongoing bleeding at operation had a significant effect on postoperative mortality. Most common cause of postoperative death was hepatic failure. Child-Pugh classification and esophageal transection were significant risk factor for postoperative mortality comparing before and after year 2001. During the mean follow-up period of 33.58+/-27.08 months, there was no recurrent bleeding from gastric varices. The cumulative 5-year survival rate was 64.1%. 0f 14 patients deceased, 6 patients died of hepatocellular carcinoma. Not only there was no death caused by recurrent variceal bleeding, but there was no recurrent gastric variceal bleeding. Hepatic functional reserve and concomitant hepatocellular carcinoma were the most important prognostic factors in the long term survival by multiple regression analysis. CONCLUSION: We concluded that PD reached both low postoperative mortality and recurrent bleeding rate with good long-term survival. So it could be one of the most effective treatment for the gastric fundal variceal bleeding.
Carcinoma, Hepatocellular ; Classification ; Dissent and Disputes ; Esophageal and Gastric Varices* ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver Cirrhosis ; Liver Failure ; Mortality ; Retrospective Studies ; Risk Factors ; Splenectomy ; Surgical Procedures, Operative ; Survival Rate ; Varicose Veins

A substantial proportion of adrenal incidentalomas demonstrates subtle hormonal hypersecretion; however, adenomas that cosecrete aldosterone and cortisol are rare. We here report a case of an adrenal mass that was incidentally detected on a computed tomography scan in a 57-year-old man. The patient had a 10-year history of diabetes mellitus and a 5-year history of hypertension. Evaluation revealed hyperaldosteronemia with an elevated plasma aldosterone-to-renin ratio, hypokalemia, unsuppressed cortisol after dexamethasone administration, and elevated urinary free cortisol concentration. The appearance of the right adrenalectomy specimen indicated adrenal adenoma. Postoperatively, the blood glucose and blood pressure control improved and the urinary cortisol and aldosterone-to-renin ratio normalized. A complete endocrine evaluation in patients with incidentally discovered adrenal masses should be performed, even if the patient has a long-standing history of hypertension and diabetes, to avoid any postoperative adrenal crises.
Adenoma ; Adrenalectomy ; Adrenocortical Adenoma* ; Aldosterone* ; Blood Glucose ; Blood Pressure ; Dexamethasone ; Diabetes Mellitus ; Humans ; Hydrocortisone* ; Hyperaldosteronism ; Hypertension ; Hypokalemia ; Middle Aged ; Plasma